Andrea Jones

Care Navigator @Centene Corporation

NC, US

Develops, assesses, and coordinates care management activities based on member needs to provide quality, cost-effective healthcare outcomes. Develops or contributes to the development of a personalized care plan/service plan for members and educates members and their families/caregivers on services and benefit options available to improve health care access and receive appropriate high-quality care through advocacy and care coordination.Evaluates the needs of the member, barriers to care, the resources available, and recommends and facilitates the plan for the best outcomeDevelops or contributes to the development of a personalized care plan/service ongoing care plans/service plans and works to identify providers, specialists, and/or community resources needed for careProvides psychosocial and resource support to members/caregivers, and care managers to access local resources or services such as: employment, education, housing, food, participant direction, independent living, justice, foster care) based on service assessment and plansCoordinates as appropriate between the member and/or family/caregivers and the care provider team to ensure identified care or services are accessible to members in a timely mannerMay monitor progress towards care plans/service plans goals and/or member status or change in condition, and collaborates with healthcare providers for care plan/service plan revision or address identified member needs, refer to care management for further evaluation as appropriateCollects, documents, and maintains all member information and care management activities to ensure compliance with current state, federal, and third-party payer regulatorsMay perform on-site visits to assess member’s needs and collaborate with providers or resources, as appropriateMay provide education to care manager and/or members and their families/caregivers on procedures, healthcare provider instructions, care options, referrals, and healthcare benefits

Norfolk State University

Bachelor of Science (B.S.), Psychology

Tidewater Community College

Associate of Arts (A.A.), Social Sciences